August 14, 2013

MaineHealth head offers views on care

By Colin Woodard cwoodard@pressherald.com
Staff Writer

PORTLAND -- Bill Caron is the president and CEO of MaineHealth, Maine's largest health care delivery network, which has nine member hospitals -- plus NorDx labs and other entities -- with combined annual revenues of nearly $2 billion.

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MaineHealth CEO Bill Caron

The network, founded by Maine Medical Center in 1994, is now one of the state's largest employers, with its members employing approximately 16,000. Its hospitals are often the largest employers in their respective communities.

Over the past year, MaineHealth announced a number of cost saving measures, including 50 layoffs, a hiring freeze, the eliminaton of 175 vacated positions, and 120 voluntary buyouts at Maine Medical Center; the closure of the emergency department at St. Andrews Hospital in Boothbay Harbor; and a scaling back of the number of beds at Damariscotta's Miles Memorial Hospital.

The network has reportedly seen its cash position erode because of millions in unpaid reimbursements it is owed by MaineCare, the state's Medicaid program, and by a $160 million investment in an electronic medical records system that was failing to charge patients properly.

Caron has headed MaineHealth since October 2000 and was its vice president and treasurer for three years prior to that. He was also vice president of finance and treasurer of Maine Medical Center from 1992 to 1997. Prior to that, he spent 17 years with the global accounting firm Ernst & Young.

Caron's base salary was $1,058,110, with bonuses of $69,896 in fiscal 2011, according to MaineHealth's IRS filings.

Maine's hospitals are in the midst of a period of consolidation, with many joining networks like MaineHealth or Brewer-based Eastern Maine Healthcare Systems. They are also confronting an aging population in Maine and a shifting policy landscape under the federal Affordable Care Act (or ObamaCare), which aims, among other things, to increase access to primary care physicians.

Q: What is MaineHealth and what is its reason for existing?

It's a story that starts in the mid-1990s when a number of hospitals in the southern part of the state were talking to each other and asking if they could work together to integrate care and increase quality and patient safety. There was also the thought that you could get more efficient the more scale you had through purchasing goods and services more effectively. So they created what is now called MaineHealth, which is an integrated delivery system with a decentralized governance model. All our members retain their own boards and reserve to themselves, to the local community, a certain level of decision making. A lot of systems out there are more top-down than ours.

So what you have seen over the past 16 years is the building of a very significant health system relative to the size of Maine. Our service area is the 11 southernmost counties in the state, and inside those counties we are the dominant provider of care. Our vision and mission is to work together so that our communities are the healthiest in America.

Q: What are the challenges facing health care providers in Maine and networks like yours?

The focus is on what I would call delivery system redesign. How are we going to pay for the care of this baby boomer generation that is coming on? As everyone knows, the older people are, the more resources they consume. But we have this tsunami coming. As our population ages, our Medicaid population is going to explode on us, particularly in this state, and it breaks the bank.

So if we don't figure out how to provide that care more efficiently and with better quality, and take those dollars we save to pay for the added demand of the baby boomer generation, then we're in trouble. The system is going to collapse.

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